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Acknowledgments ix Introduction: Cote-d'Ivoire and Triage in the Time of AIDS 1 1. Testimonials That Bind: Organizing Communities with HIV 15 2. Confessional Technologies: Conjuring the Self 35 3. Soldiers of God: Together and Apart 61 4. Life Itself: Triage and Therapeutic Citizenship 89 5. Biopower: Fevers, Tribes, and Bulldozers 111 6. The Crisis: Economies, Warriors, and the Erosion of Sovereignty 137 7. Uses and Pleasures: The Republic Inside Out 157 Conclusion: Who Lives? Who Dies? 175 Notes 189 References 205 Index 229
Ethnography that examines the global civil rights movement demanding access to HIV treatments as it has developed in West Africa
Vinh-Kim Nguyen is Associate Professor of Social and Preventive Medicine in the School of Public Health at the University of Montreal.
"In Republic of Therapy, the experts range from the international AIDS industry to Ivorian healers, activists, and friends of the author. Nguyen, a medical doctor and anthropologist, writes from his work as a community organizer among HIV-positive groups in West Africa, as an AIDS physician in an Abidjan clinic, and as an ethnographer in the city's subcultures... The book is important for understanding how 'technologies of the self' used by people in local organizations resemble both colonial patterns of interaction and international AIDS organizations' confessional theatre. AIDS treatment technologies make for a particular kind of politics." - Lisa Ann Richey, African Affairs "A tour de force. A Republic of Therapy is a shrewdly theorized ethnography of AIDS practices, technologies, drugs, confessions, and individuals in West Africa. Tracing how triage, confession, and activism emerged from 1995 in Abidjan, site of one of the very first HIV treatment programs in Africa, Vinh-Kim Nguyen analyses the workings and unintended consequences of a new politics of biomedical survival. Scrupulously un-romanticized, the book reveals francophone West Africans competing to stay alive in the time of AIDS, while actively linking their selves and bodies to practices of triage and confession. This sharp, urgent, and intellectually daring book brings uncommon critical insight to the violence of humanistic global health interventions and the searing paradoxes of triage."--Nancy Rose Hunt, author of A Colonial Lexicon: Of Birth Ritual, Medicalization, and Mobility in the Congo "The activist, physician, and anthropologist Vinh-Kim Nguyen has written an engaged, rigorous, and compelling account of the years when, in West Africa, AIDS treatment started to become available and persons living with HIV began to organize. With insight and sympathy, he explores how new political forms were thus invented in Cote d'Ivoire and Burkina Faso, combining therapeutic sovereignty and health democracy, triage of patients and empowerment of communities, confessions and accusations."--Didier Fassin, author of When Bodies Remember: Experiences and Politics of AIDS in South Africa